Bethesda doctor ordered to pay $17M for health care fraud

A Bethesda doctor must pay the government more than $17 million in fines for allegedly submitting false Medicare and Medicaid claims and double- billing for nuclear stress test studies.

On Tuesday, the U.S. District Court for the District of Columbia entered judgement for the money against Dr. Ishtiaq Malik, a nuclear cardiologist who practices in D.C.

The federal government says Malik double-billed for the nuclear stress tests by categorizing the stress and rest phases, which can be conducted over multiple days, as two separate tests. The test must be coded and submitted as one test.

Malik allegedly submitted false claims to Medicare, District of Columbia Medicaid, Maryland Medicaid, TRICARE and the Federal Employees Health Benefits Plan. The government also says Malik engaged in a practice known as “unbundling,” or billing for services already included in the payment for nuclear stress tests, including intravenous injections, drug infusions, 3D rendering and drug administration.

Under the False Claims Act, the government can recover three times its damages, plus penalties, meaning Malik now owes $17 million.

“This doctor fraudulently diverted critical resources from government health care programs, contributing to the rising cost of health care for all Americans,” Ronald Machen Jr., U.S. Attorney for the District of Columbia, said in a statement. “This lawsuit was designed to hold the doctor to account for bilking the taxpayer. We will do everything in our power to obtain every cent of the $17 million this doctor now owes the American people.”

The state of Maryland joined the lawsuit under its own False Claims Act. Under the judgement issued on Tuesday, Malik must pay Maryland $305,141.24, triple the amount of improperly billed services reimbursed by the Maryland Medicaid Program.

Maryland joined the federal government’s 2012 lawsuit in February, according to a statement from Maryland Attorney General Doug Gansler.

“If anyone tries to defraud Maryland taxpayers using the Medicaid Program, this office will use all the tools we have to recover that money and much more,” Gansler said. “Although we hope to never again confront this type of fraud, let this penalty send a message that this type of theft of taxpayer dollars carries a severe penalty.”

Malik and his companies were also ordered to pay penalties of $5,500 for each false claim submitted to a government health care program, totaling an additional $1,672,000. Maryland’s share of that amount has yet to be determined, according to Gansler’s press release.